Taking Sides: Clashing Views on Controversial Issues in Food and Nutrition

PART 1. Dietary Patterns and Guidelines

ISSUE 1. Does the USDA Pyramid Describe an Optimal Dietary Pattern?

YES:: Marion Nestle, from “In Defense of the USDA Food Guide Pyramid,” Nutrition Today (September/October 1998)

NO:: Walter C. Willett with P. J. Skerrett, from Eat, Drink, and Be Healthy:: The Harvard Medical School Guide to Healthy Eating (Simon & Schuster, 2001)

New York University nutrition professor Marion Nestle says that the U.S. Department of Agriculture (USDA) Food Guide Pyramid’s hierarchical design and emphasis on plant-based diets represent a significant advance over previous federal food guides and that a few adjustments to the Pyramid’s design would further strengthen its message and respond to most of the concerns of critics. Harvard School of Public Health nutrition professor Walter C. Willett and author P. J. Skerrett argue that the Pyramid at best offers “wishy-washy, scientifically unfounded advice” and at worst contributes to poor health. Overall, the Pyramid represents “a missed opportunity to improve the health of millions of people.”

ISSUE 2. Can All Foods Fit Into a Healthful Diet?

YES:: Jeanne Freeland-Graves and Susan Nitzke, from “Position of the American Dietetic Association:: Total Diet Approach to Communicating Food and Nutrition Information,” Journal of the American Dietetic Association (January 2002)

NO:: Suzanne Havala, from Good Foods, Bad Foods:: What’s Left to Eat? (Chronimed Publishing, 1998)

Nutrition professors Jeanne Freeland-Graves and Susan Nitzke speak for the American Dietetic Association (ADA) when they say that there is no such thing as a good or bad food:: all foods can fit into healthful diets. Their approach to nutrition advice emphasizes the total diet, appropriate portion sizes, moderation and balance in food intake, obtaining nutrients from foods rather than supplements, and regular physical activity. Nutrition professor Suzanne Havala counters that some foods are better for health than others and that saying otherwise is just a way to rationalize the dietary status quo and protect the commercial interests of the food industry.

ISSUE 3. Are the New Dietary Reference Intakes for Calcium Appropriate?

YES:: Rebecca J. Bryant, Jo Cadogan, and Connie M. Weaver, from “The New Dietary Reference Intakes for Calcium:: Implications for Osteoporosis,” Journal of the American College of Nutrition (May 1999)

NO:: B. E. Christopher Nordin, from “Calcium Requirement Is a Sliding Scale,” American Journal of Clinical Nutrition (June 2000)

Nutrition professor Rebecca J. Bryant and her colleagues say that to prevent bone fractures, the recommended intake of dietary calcium should be 1,000 to 1,200 milligrams (1 to 1.2 grams) a day for adults. Biochemist B. E. Christopher Nordin says that calcium requirements are as much or more dependent on intake of other dietary factors than they are of calcium. Adults with low intakes of protein, phosphate, and sodium can maintain bone health on intakes as low as 400 milligrams of calcium per day.

PART 2. Nutrition and Health

ISSUE 4. Are Added Sugars Harmful to Health?

YES:: Barbara V. Howard and Judith Wylie-Rosett, from “Sugar and Cardiovascular Disease,” Circulation (July 23, 2002)

NO:: Anne L. Mardis, from “Current Knowledge of the Health Effects of Sugar Intake,” Family Economics and Nutrition Review (2001)

Researchers Barbara V. Howard and Judith Wylie-Rosett, representing the American Heart Association (AHA), state that high sugar consumption increases risk factors for heart disease and may adversely affect control of diabetes. Physician Anne L. Mardis, representing the U.S. Department of Agriculture’s (USDA’s) Center for Nutrition Policy and Promotion, says that the intake of sugar has no relation to the risk of heart disease or diabetes.

ISSUE 5. Do Foods With a High Glycemic Index Increase Disease Risk?

YES:: David S. Ludwig, from “The Glycemic Index:: Physiological Mechanisms Relating to Obesity, Diabetes, and Cardiovascular Disease,” Journal of the American Medical Association (May 8, 2002)

NO:: F. Xavier Pi-Sunyer, from “Glycemic Index and Disease,” American Journal of Clinical Nutrition (July 2002)

Physician-scientist David S. Ludwig says that habitual consumption of foods with a high glycemic index alters metabolism in ways that increase the risk for obesity, type 2 diabetes, and heart disease. He maintains that the glycemic index should be used as a guide to food selection. Physician-scientist F. Xavier Pi-Sunyer says that research on the health effects of high-glycemic index foods is uncertain and inconclusive. He concludes that it would be a mistake to suggest avoiding foods just because they display a high glycemic index.

PART 3. Diet, Physical Activity, and Health

ISSUE 6. Is Body Weight a Reliable Measurement of Overall Health?

YES:: Alison E. Field et al., from “Impact of Overweight on the Risk of Developing Common Chronic Diseases During a 10-Year Period,” Archives of Internal Medicine (July 9, 2001)

NO:: Annemarie Jutel, from “Does Size Really Matter? Weight and Values in Public Health,” Perspectives in Biology and Medicine (Spring 2001)

Epidemiologist Alison E. Field and her team of investigators say that overweight adults are at increased risk of chronic disease, even if they are not obese. Health sociologist Annemarie Jutel says that the risks of overweight are exaggerated and that its cure—dieting—is a greater hazard.

ISSUE 7. Can Low-Carbohydrate, Higher-Fat Diets Promote Health and Weight Loss?

YES:: Gary Taubes, from “What If It’s All Been a Big Fat Lie?” The New York Times Magazine (July 7, 2002)

NO:: Bonnie Liebman, from “Big Fat Lies:: The Truth About the Atkins Diet,” Nutrition Action Health Letter (November 2002)

Freelance science journalist Gary Taubes says that government advice to eat less fat produces the opposite of its intended effect; it makes Americans fatter. Instead, high-fat diets help people to lose weight and reduce chronic disease risk factors. Science journalist Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest (CSPI), a consumer advocacy organization in Washington, D.C., counters that high-fat diets raise risks for heart disease and cancer and, when excessive in calories, induce weight gain.

ISSUE 8. Must Exercise Be Daily and Intense to Prevent Chronic Disease?

YES:: Institute of Medicine of the National Academies, from “Physical Activity,” Dietary Reference Intakes:: Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids, A Report of the Institute of Medicine (September 5, 2002)

NO:: I-Min Lee et al., from “Physical Activity and Coronary Heart Disease in Women:: Is �No Pain, No Gain’ Passé?” Journal of the American Medical Association (March 21, 2001)

To prevent weight gain and chronic disease, the Institute of Medicine of the National Academies recommends 60 minutes of daily physical activity of moderate intensity (such as walking at a rate of 4 to 5 miles per hour) in addition to activities normally performed as part of a sedentary lifestyle. Associate professor at the Harvard School of Public Health I-Min Lee and colleagues say that even light-to-moderate activity lowers heart disease rates among women and that as little as one hour of walking per week predicts lower risk.

ISSUE 9. Do Education Campaigns Induce Communities to Change Their Diets and Improve Health?

YES:: Bill Reger, Margo G. Wootan, and Steven Booth-Butterfield, from “A Comparision of Different Approaches to Promote Community-Wide Dietary Change,” American Journal of Preventive Medicine (April 2000)

NO:: Stephen P. Fortmann and Ann N. Varady, from “Effects of a Community-Wide Health Education Program on Cardiovascular Disease Morbidity and Mortality:: The Stanford Five-City Project,” American Journal of Epidemiology (April 2000)

West Virginia University researchers Bill Reger and Steven Booth-Butterfield and Center for Science in the Public Interest researcher Margo G. Wootan say that advertising and public relations campaigns can induce the public to make more healthful dietary choices. Researchers Stephen P. Fortmann and Ann N. Varady say that even long-term educational interventions in communities have little effect on overall trends in chronic disease risk.

PART 4. Supplements and Functional Foods

ISSUE 10. Can Vitamin and Mineral Supplements Help Prevent Chronic Disease?

YES:: Robert H. Fletcher and Kathleen M. Fairfield, from “Vitamins for Chronic Disease Prevention in Adults:: Clinical Applications,” Journal of the American Medical Association (June 19, 2002)

NO:: Demetrius Albanes, from “¿-Carotene and Lung Cancer:: A Case Study,” American Journal of Clinical Nutrition (June 1999)

Physicians Robert H. Fletcher and Kathleen M. Fairfield say that even in populations where deficiencies are rare, “suboptimal” vitamin intakes are common, especially among the elderly; consequently, adults should take vitamin supplements to reduce their risk for chronic diseases. Cancer prevention researcher Demetrius Albanes argues that foods—not supplements—are associated with cancer prevention and that supplemental beta-carotene, for example, may have adverse effects on health. He argues that more evidence is needed before advising adults to take nutrient supplements.

ISSUE 11. Will Taking Herbal Supplements Enhance Mental Ability?

YES:: Pierre L. Le Bars et al., from “A Placebo-Controlled, Double-Blind, Randomized Trial of an Extract of Ginkgo Biloba for Dementia,” Journal of the American Medical Association (October 22/29, 1997)

NO:: Paul R. Solomon et al., from “Ginkgo for Memory Enhancement:: A Randomized Controlled Trial,” Journal of the American Medical Association (August 21, 2002)

Researcher Pierre L. Le Bars and his colleagues say that supplements of ginkgo biloba improve the cognitive and social functioning of people with Alzheimer’s or other types of dementia. Researcher Paul R. Solomon and his colleagues say that ginkgo biloba has no beneficial effect on memory or cognitive function in healthy older adults.

ISSUE 12. Can Functional Foods and Nutraceuticals Benefit Health?

YES:: Cyndi Thomson, Abby S. Bloch, and Clare M. Hasler, from “Position of The American Dietetic Association:: Functional Foods,” Journal of The American Dietetic Association (October 1999)

NO:: Editors of Consumer Reports on Health, from “The New Foods:: Functional or Dysfunctional?” Consumer Reports on Health (June 1999)

Cyndi Thomson et al., representatives of the American Dietetic Association (ADA), say that fortified, enriched, or enhanced “functional” foods can improve health. The editors of Consumer Reports on Health say that the purpose of functional foods is not to improve health but rather to boost the profits of manufacturers.

PART 5. Nutrition and Food Policy

ISSUE 13. Does Widespread Hunger Exist in America?

YES:: Mark Nord, Margaret Andrews, and Steven Carlson, from “Measuring Food Security in the United States:: Household Food Security in the United States, 2001,” Food Assistance and Nutrition Research Report Number 29, A Report of the Food and Rural Economics Division, Economic Research Service, United States Department of Agriculture (October 2002)

NO:: Robert E. Rector, from “The Myth of Widespread American Poverty,” The Heritage Foundation, (September 18, 1998)

Mark Nord et al., U.S. Department of Agriculture (USDA) economists, estimate that 11.5 million U.S. households do not have enough food to meet basic needs; of these, 3.5 million households sometimes go hungry for lack of resources to buy food. Robert E. Rector, policy analyst for the Heritage Foundation, a Washington, D.C.–based think tank, finds little evidence of hunger among the poor; on the contrary, he argues that their principal nutrition problems are overweight and obesity.

ISSUE 14. Should Mothers Infected With the AIDS Virus Breastfeed Their Infants?

YES:: Jean Humphrey and Peter Iliff, from “Is Breast Not Best? Feeding Babies Born to HIV-Positive Mothers:: Bringing Balance to a Complex Issue,” Nutrition Reviews (April 2001)

NO:: Dorothy Mbori-Ngacha et al., from “Morbidity and Mortality in Breastfed and Formula-Fed Infants of HIV-1–Infected Women:: A Randomized Clinical Trial,” Journal of the American Medical Association (November 21, 2001)

Johns Hopkins public health researcher Jean Humphrey and her Zimbabwe-based colleague Peter Iliff argue that the mortality risks of formula feeding are so high that infants of mothers infected with Human Immunodeficiency Virus (HIV), the virus that causes Acquired Immunodeficiency Syndrome (AIDS), have a better chance of survival if they are breastfed. Pediatrician Dorothy Mbori-Ngacha and her research colleagues argue that formula feeding is a safe alternative to breastfeeding and ensures longer survival of infants of HIV-infected mothers.

ISSUE 15. Is Organically Grown Food Better Than Conventionally Grown Food?

YES:: John P. Reganold et al., from “Sustainability of Three Apple Production Systems,” Nature (April 19, 2001)

NO:: Dennis Avery, from “The Fallacy of the Organic Utopia,” in Julian Morris and Roger Bate, eds., Fearing Food:: Risk, Health, and Environment (Butterworth-Heinemann, 1999)

Agricultural researchers John P. Reganold and colleagues say that organic farming methods produce apples that are sweeter, less tart, more profitable, more energy efficient, and more environmentally and economically sustainable than those grown by conventional farming methods. Agricultural economist Dennis Avery counters that as a global food production system, organic farming would be an environmental disaster, an imminent danger to wildlife, and a hazard to public health.

ISSUE 16. Will Irradiation Improve the Safety of the Food Supply?

YES:: Olivia Bennett Wood and Christine M. Bruhn, from “Position of the American Dietetic Association:: Food Irradiation,” Journal of the American Dietetic Association (February 2000)

NO:: George L. Tritsch, from “Food Irradiation,” Nutrition (July–August 2000)

Nutritionists Olivia Bennett Wood and Christine M. Bruhn, speaking for the American Dietetic Association (ADA), say that irradiation enhances the safety and quality of the food supply and helps protect consumers from foodborne illness. They maintain that officials should educate the public that irradiated foods are safe and offer a wider variety of such foods in the marketplace. Cancer researcher George L. Tritsch argues that the principal beneficiary of food irradiation is the food industry; the public derives no tangible benefit from this technology but bears all of its safety risks. He concludes that the long-term consequences of food irradiation will be far worse than any disease against which it may have been directed.

ISSUE 17. Does the World Need Genetically Modified Foods?

YES:: Robert B. Horsch, from “Does the World Need GM Foods? Yes,” Scientific American (April 2001)

NO:: Margaret Mellon, from “Does the World Need GM Foods? No,” Scientific American (April 2001)

Scientist-official Robert B. Horsch, of the Monsanto Corporation, says that use of biotechnology will allow more food to be produced on less land with less depletion or damage to water resources and biodiversity. He insists that agricultural biotechnology is imperative for meeting growing demands for food. Scientist-official Margaret Mellon, of the Union of Concerned Scientists, says that science has yet to demonstrate that the benefits of food biotechnology outweigh the risks. She concludes that biotechnology is no panacea for world hunger and that it diverts attention from more effective methods for solving world food problems.